Information Collection Request

Development of a Health Information Rating System (HIRS)

ICR 201210-0935-001 · OMB 0935-0207 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #4 Health Education Materials & Questionnaire - Colonoscopy Form and Instruction New Available
Form Form #3 Health Education Materials & Questionnaire - Inhaler Form and Instruction New Available
Form Form #2 S-TOFHLA Questionnaire Form and Instruction New Available
Form Form #1 Demographic Questionnaire Form New Available
Supporting Statement B -- Development of a Health Information Rating System 9-19-2012.doc Supporting Statement B Uploaded 2012-10-05 Available
Attachment H - Consent Form.doc Supplementary Document Uploaded 2012-10-05 Available
Attachment G - Federal Register Notice.pdf Supplementary Document Uploaded 2012-10-05 Available
Attachment A - Description of All Project Tasks.docx Supplementary Document Uploaded 2012-10-05 Available
Supporting Statement A -- Development of a Health Information Rating System 9-18-2012.doc Supporting Statement A Uploaded 2012-10-05 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
204410 Health Education Materials & Questionnaire - Colonoscopy Form and Instruction NewHealth Education Materials & Questionnaire - Colonoscopy
204409 Health Education Materials & Questionnaire - Inhaler Form and Instruction NewHealth Education Materials & Questionnaire - Inhaler
204408 S-TOFHLA Questionnaire Form and Instruction NewS-TOFHLA Questionnaire
204407 Demographic Questionnaire Form NewDemographic Questionnaire

ICR Details

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table that charts list comparision
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
Demographic Questionnaire Form #1
Health Education Materials & Questionnaire - Colonoscopy Form #4
Health Education Materials & Questionnaire - Inhaler Form #3
S-TOFHLA Questionnaire Form #2



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